It’s not unlike school homework. Among the medley are students who complete the work diligently, and the more unruly who find every conceivable excuse to avoid it.
Apparently, in a physiotherapist’s world, getting patients to stick to their home exercise programmes is just as challenging.
Research carried out in 2003 showed that while 70 per cent of patients comply in the short term, that figure drops to 20 per cent for longer term programmes.
This “non-compliance”, as it is politely termed, leads to slower recovery from injury, and potentially the need for more costly and invasive surgical procedures.
Digital revolution
One Kerry e-health start-up thinks the answer lies in the digital revolution that has already seeped into so many aspects of our lives.
Would people be more likely to stay the course if they had clear videos that could be streamed to their tablet or smartphone, rather than the print-outs and drawings of “stickmen” which they are so often given from clinics today?
Yes, according to the founder of HealthClinicPlus, Aoife Ní Mhuirí.
“If you are talking about exercises for a specific rehabilitation, it needs to be quite precise. And often for someone without physio training, it is quite difficult to figure out the actual movement pattern.
“A lot of the time people don’t know what they are doing,” she says.
Most people know intuitively that it is easier to learn a movement by mimicking a video than by following written instructions and static pictures, and research backs that up.
Using video instead of printed illustrations to mimic exercise leads to better learning of the correct form and posture, along with higher motivation levels.
Established in 2011, HealthClinicPlus spent its first year in business shooting almost 1,000 videos that make up its library of rehabilitation clips.
Its staff is 50/50 chartered physiotherapists to IT experts, a collaboration that melded the physio expertise in the videos and the tech savvy to deliver them in the most user-friendly platforms possible.
The library of videos, dealing with pretty much every muscle in the body, is licensed out to physiotherapists who then “prescribe” videos to their patients.
Information feedback
The company recently launched an app that feeds information back to the physiotherapist.
Patients can log their exercise sessions, their pain levels and how challenging the movements feel.
If they are progressing well, the physiotherapist can remotely update the programme to the next level, removing the need for a face-to-face consultation in certain cases.
“My own background is in clinical practice [chartered physiotherapy] and I always had this challenge of trying to get patients to do their exercises properly and more often,” says Ní Mhuirí.
The idea of creating a database of videos to tackle the problem came from her work as a lecturer in the Institute of Technology in Tralee where she saw first-hand the effectiveness of video in teaching students traditionally very static content like anatomy.
“Their learning was so much better than when just engaging with journals and text. That is where the idea came from.
“I thought, why don’t we use the tools we have available to us today that we didn’t have 20 years ago to teach our patients how to do their exercises and help them get themselves better?”
As well as a partnership with the Irish Society of Chartered Physiotherapists who will promote the video library to members, the company has also teamed up with the GAA for a programme aimed at reducing injury in Gaelic games.
Gaelic 15 is a 15-minute warm-up that has been shown to reduce the risk factors for injury, particularly cruciate ligament injury.
Ní Mhuirí predicts growth in e-health across all areas of healthcare, not just physiotherapy.
“Two or three years ago, your average 65 year old may not have had a smartphone but that is changing very rapidly.
“There is huge opportunity there,” she adds.
